20130337 Ver 1_Application_20130323

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STATE OF NORTH CAROLINA ' "i5l�gi�BA 4�Cy
DEPARTMENT OF TRANSPORTATION
PAT MCCRORY
GOVERNOR
March 28, 2013
Ms. Liz Hair
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801 -5006
ANTHONY J. TATA
SECRETARY
Z,_ Or, 1, 3, 0 3* 3 7
SUBJECT: Pipe Replacement, SR 1234 (Harvey Road), Lincoln County, UT to Hord Creek
Dear Ms Hair:
The North Carolina Department of Transportation proposes to replace a deteriorating 32 foot,
72" CMP with a 50 foot, 72" CMP on SR 1234 (Harvey Road) in Lincoln County on an UT to
Hord Creek. There is an existing headcut visible approximately 30 feet upstream of the existing
pipe. The increase in pipe length increases the new pipe slope; therefore, to prevent the existing
headcut from worsening, it is proposed to place the new pipe at streambed elevation rather than
burying the inverts per regulation. Approximately 10 feet of Class II riprap will be utilized at the
pipe inlet/outlet for structure protection. Due to the existing site conditions, NCDOT requests
a waiver from the Regional Condition 2(b)(e) permit depth specification, for the
construction of this project. A total of ten feet of rip rap will be placed around the pipe inlet
and outlet for structure stabilization. A temporary cofferdam pumping system will be used to
divert the stream around the construction site, as needed. Areas affected by temporary cofferdam
system will be restored to pre - project conditions.
This office has conducted a GIS and field survey for the project for historical sites and
threatened /endangered species sites. No sites listed on the National Register of Historic Places
are located in the vicinity of the project nor did there appear to be any eligible structures. The
federally listed species for Iredell County (USFWS listed date September 22, 2010) include the
Dwarf - flowered heartleaf (Hexasrylis naniflora). The Division 12 Environmental Office
conducted a threatened /endangered species survey on March 11, 2013. The federally listed
species for Lincoln County (USFWS listed dated September 22, 2010) include Michaux's sumac
(Rhus michauxii) and the dwarf - flowered heartleaf (Hexasrylis nan0ora). National Heritage
Program records document the nearest Michaux's Sumac location approximately 19.5 miles
southeast (in Mecklenburg county) of the proposed project area. There are no known sites of
Michaux's sumac in Lincoln County. The sumac is typically found in sandy or rocky, open
woods and appears to survive best in areas with some disturbance, such as artificially or naturally

SR 1234 (Harvey Road)
Page 2
March 28, 2013
maintained clearings. There is no suitable habitat within the proposed project area and no
species were observed. No impact on this species is anticipated. National Heritage Program
records document the nearest dwarf - flowered heartleaf location approximately 1.5 miles east of
the proposed project area. The heartleaf is usually found on dry to moist ravine slopes (usually
north facing and of the oak - hickory-pine forest type) and in boggy areas near springheads. There
is no suitable habitat within the proposed project area and no species were observed. No impact
on this species is anticipated.
The project area is not located within' /2 mile of any critical watershed area nor is SR 1234 a rural
or urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous
spill basin checklist.
I have enclosed a pre - construction notification for a Nationwide #14, sketch of planned activities
and a location map relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
• Work order number: 12B.205511
• TIP #: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at (704) 480 -9044. Thank you for
your time and consideration on this matter.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY:
Trish Beam
Division 12 Environmental Supervisor

WATF�� MAR 2 2013 b
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o GENH - boATER OUAIi 1 y
WETWID5 AND STi?Ri�yyATtR BR; "NCH
Office Use Only:
Corps action ID no.
DWQ project no. .
Form Version 1.3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
Pre- Construction Notification PC Form
A. Applicant Information
1.
Processing
1 a. Type(s) of approval sought from the
Corps:
® Section 404 Permit El Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
® Yes ❑ No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
SR 1234, Harvey Road
2b.
County:
Lincoln
2c.
Nearest municipality / town:
Lincolnton
2d.
Subdivision name:
NA
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
NCDOT Right of Way
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
3e.
City, state, zip:
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ❑ Other, specify:
4b.
Name:
Mike Holder
4c.
Business name
(if applicable):
N.C. Department of Transportation, Division 12
4d.
Street address:
1710 East Marion Street
4e.
City, state, zip:
Shelby, NC 28151
4f.
Telephone no.:
704- 480 -9020
4g.
Fax no.:
704 - 480 -5401
4h.
Email address:
mholder @ncdot.gov
&
Agent/Consultant'lnformation (if applicable)
5a.
Name:
Trish Beam
5b.
Business name
(if applicable):
N.C. Department of Transportation, Division 12
5c.
Street address:
1710 East Marion Street
5d.
City, state, zip:
Shelby, NC 28151
5e. Telephone no.:
704 - 480 -9044
5f.
Fax no.:
704 - 480 -5401
5g.
Email address:
pdbeam @ncdot.gov
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
NA
Latitude: 35.4482 Longitude: - 81.2748
1 b. Site coordinates (in decimal degrees):
(DD DDDDDD) (- DD.DDDDDD)
1 c. Property size:
<.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Ut to Hord Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
WS -IV
2c. River basin:
Catawba
3. Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Pipe is on a paved secondary road. Landuse is residential.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
100
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace a deteriorating pipe for the safety of the traveling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
NCDOT proposes to replace an existing 32 -foot 72" CMP with a 50 -foot 72" CMP. There is an existing headcut visible
approximately 30 feet upstream of the existing pipe. The increase in pipe length increases the pipe slope; therefore, to
prevent the existing headcut from worsening, it is proposed to place the new pipe at streambed elevation rather than
burying the inverts per regulation. Approximately 10 feet of Class II riprap will be utilized at the pipe inlet/outlet for
structure protection.
A temporary cofferdam pumping system will be used to divert the stream flow around the construction sites as needed.
Area affected by temporary cofferdam system will be restored to pre - project conditions. All Best Management Practice's
will be utilized during the course of the project. The Project will be constructed using typical heavy equipment (trackhoe,
backhoe, etc.).
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments: Jurisdictional stream determinations made by
the Division 12 DEO.
4b. If the Corps made the jurisdictional determination, what type
❑ Preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company:
Name (if known):
Other:
[4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

S. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ -
W2 ❑ P ❑ T
❑ Yes
❑ No
❑ ,Corps
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Increase in pipe
length
Ut to Hord Creek
® PER
❑ INT
® Corps
® DWQ
5
18
S2 ®P ❑ T
Riprap for
structure
Ut to Hord Creek
® PER
❑ INT
® Corps
® DWQ
5
10
stabilization
S3 ❑ P ®T
Cofferdam bypass
Ut to Hord Creek
® PER
❑ INT
® Corps
® DWQ
5
70
pumping
S4 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 F1 P F] T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
"28
3i. Comments: " Permanent impacts
Page 5 of 11
PCN Form — Version 1.3 December 1b, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse El Tar-Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number-
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
❑Yes
131 ❑P ❑T
❑ No
❑Yes
B2 ❑ P ❑ T
❑ No
El Yes
B3 ❑P ❑T
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6, of 11
PCN Form -Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
In an effort to avoid exacerbating an existing headcut, the new pipe will be installed in at streambed elevation rather than
burying the pipe inverts per regulation.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes -
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non - riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
S. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
NA %
2b.
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: Complies
with NCDOT's individual
NPDES permit NCS000250.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
® DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
NA
❑ Phase II
3b.
Which of the following locally - implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006 -246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ❑ No
use of public (federal /state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes El No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after - the -fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
.
El Yes No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The project is classified as a minimum critieria project which has low potential for cumulative /indirect impacts and will not
result in additional development which could impact water quality.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, ind icate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program database and on site surveys.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
No salt marshes, oyster reefs, or seagrass beds in the vicinity of the project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
The State Historic Preservation Office resources and the National Register of Historic Places werer reviewed for historic
sites in the vicinity of the project; however, the pipe replacement projects occur within a previously impacted area (NC
DOT Right of Way).
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM panel number: 3710362200J
Mike Holder
f� , �o�C{ �// V
3/28/13
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
Is provided.)
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 12 County: Lincoln Project ID: 12B.205511
River Basin: Catawba Bridge No: NA
Route: SR 1234
Water Quality Criteria:
Stream: UT to Hord Creek
Yes No
Stream Crossing Blue Line On USGS 1-7.� r
ORW F W.
WSI F
WS II,III OR IV, Crossing Within 0.5mi of W.S. Critical Area r,,
Roadway Criteria:
Route Designation-
Additional Site Information:
Yes No
Arterial Urban r w
Arterial Rural F
Yes No
Is a Hazardous Spill Basin Required? - r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).

Notes:
1) Pumping system to be used to
divert the stream around the
construction site as needed.
2) Any contaminated water within
the construction site is to be / h°
pumped into a silt bag.
oc
3) Silt fence is to be placed around /
stockpile and project as it allows /
4) Upon completion of the project all
silt fences are to be placed as
'
needed. Also seeding and mulching I
of disturbed areas. I
5) Divert runoff into storage basins or into I
TRSC -A before leaving the project Place I
contaminated devices at the end of silt fence I
I
6) Place TRSC -A's or Special Sediment Control
I
Fence in the low points with weep holes in
silt fence as needed I Unnamed Tributary to
E
I Catawba River
7) Reference the Best Management
��
Practices for Construction and
Maintenance Activities by the
NCDOT Chapter 4 CL
RD Class II Rip Pop or Shot Rock
MH I on all Four Corners not to
exceed 5'
I 22
Existing 72" x 32' CMP to be Removed
j
I Existing Drainage Ditch
M
( Pole
Proposed 72" x 50' CMP I I
with Dbl Headwalls
I
I I I
Nail set in Q
a 20" Poplar
i Q
12th Div. NOOT
WBridge Maintenance
-> Pipe Replacement
9
Q Harvey Rd. SR 1234
= Lincoln County
3/28/13
Revised FB: B -3 DR5

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